Rep John Conyers

(Best Syndication News) If you are skeptical about the new Harry and Louise ads on Television promoting health care reform, you were not alone. This is the same couple of actors who stared in the 1993 commercials that were used to defeat the program proposed by President Bill Clinton.

Back in the 1990s, the commercial was credited with helping crush a proposed national health care program. Today the actors are promoting health reform without promoting a Presidential candidate or a specific plan. Yes, even the health insurance industry is promoting some form of Universal Health Care. You may ask yourself why the health insurance industry is promoting a plan that could lead to their demise. Read further:

Sponsors of the New Harry and Louise Ads

The new advertisements will appear on television during the 2008 Democratic and Republican conventions. They are sponsored by various groups including The American Cancer Society Cancer Action Network, the American Hospital Association, the Catholic Health Association, Families USA, and the National Federation of Independent Business. This time the couple urges health care reform.

Universal Health Care vs. a Single Payer System

There is a subtle difference between a “single payer system” and a “universal health care system”. A single payer system means that one entity, like the government, pays for everyone’s health care or insurance.

Universal health care could mean a single payer system, but it could also mean something else. Universal health care could mean a law that requires everyone to purchase health insurance. The insurance companies could benefit from a universal health care system that forces everyone to buy a policy.

House Bill HR 676 IH

HR 676 is sponsored by Congressman John Conyers, Dennis Kucinich and several others. The bill would provide for a single payer medical system. Introduced in 2003, the bill now has 91 cosponsors. It is currently in the House Energy and Commerce's Subcommittee on Health.

The bill, called the “United State Health Insurance Act” and sometimes referred to as “Improved Medicare for All Act”, covers all residents residing in the United States and territories. After filling out a form that shall not be longer than two pages, individuals will receive a card with a unique number that is different than their social security number.

Services Covered

The benefits include “all medically necessary services” including dental, mental, surgical and even prescription drugs. The services do not include cosmetic dentistry, laser eye surgery for cosmetic services (ie Lasik). Hearing aids, eye glasses, chiropractic services, medical equipment, and long term care would be covered though.

Deductibles, Co-pays and Co-Insurance

If this bill is passed and signed into law, there will be no deductibles, no co-payments, nor any coinsurance requirements. There will not be any cost-sharing at all, and enlisted doctors will be prohibited from charging extra.

Non Profit Only

Health insurance companies will still exist, but no participating provider can be a participant unless it is not for profit. All companies taking part must be non-profit.

Hospitals

So what will happen to the hospitals? The bill states: The owners of such investor-owned providers shall be compensated for the actual appraised value of converted facilities used in the delivery of care. The government (via the Treasury) will buy hospitals.

Health Maintenance Organizations or HMOs

The bill requires that HMOs pay their doctors a “reasonable salary”. Health insurance companies can also sell benefits not covered by the Act, like cosmetic surgery and other non-necessary procedures.

How Do Doctors Get Paid?

The states will continue to license the doctors, but the Federal Government will pay them, including dentists, doctors of osteopathy, psychologists, chiropractors, doctors of optometry, nurse practitioners, nurse midwives, physicians’ assistants, and other “advanced practice” licensed clinicians.

Prices will be negotiated annually and services will be paid through regional offices. Institutional providers will be paid a lump sum to cover all operating expenses under a global budget.

Everyone will be paid according to a prevailing wage. Regional differences will also be considered. For instance, a doctor in Los Angeles may get paid more for a procedure than one in Idaho. It costs more to live in LA.

Billing and Health Histories

Pre-existing conditions will be a thing of the past. Medical histories can be centralized in a computer database. Patients will not have to worry about their pre-existing conditions.

Doctors will also be required to use an electronic billing system. This is expected to save money and end billing confusion. If a doctor is not paid within 30 days, there is a provision to allow for interest to be paid. Doctors employed by and HMO will be “required” to be paid a salary.

Long Term Care Providers

Local long-term care providers for the full range of needed services, including in-home, nursing home, and community based care will be paid out the “global budget.” In home care will be “favored”. The price of these services will be negotiated each year.

Generic and Name Brand Drugs

Although name brand drugs will be allowed, generic ones may be preferred. Doctors shall “promote” the use of generic drugs.

How Will The Program Be Financed

Initially the plan provide for the sale of Treasury Bonds to buy facilities and get the program going. This should be completed within 15 years of approval. Taxes will then pay for the program.

There will be an increase in some taxes. The top 5 percent income earners will see a tax increase. There will be a “modest and progressive” excise tax on payroll and self-employment income. Progressive means the more you make, the more you pay as a percentage of your income. Our income tax is a progressive tax already.

The plan also calls for a “small” tax on stock and bond transactions.

The Board of Universal Quality and Access

There are all sorts of competing interests in the medical industry. There are the doctors who want to get paid more and patients who want the best service and coverage. A Board of Universal Quality and Access shall be appointed to make equitable decisions.

At least one member from each group shall be appointed:

1) Health Care Professionals

2) Labor Unions

3) Institutional Providers

4) Citizen Patients Advocates

5) Health Care Advocacy Groups

Each member shall be appointed for a term of 6 years. The President can stager the terms so no more than 3 member terms expire at once. The Board shall meet “at least” twice a year and shall advise the Secretary and the Directors on a regular basis.

Directors

Each state will have a director. The directors will all report to the national Board of Universal Quality and Access. The director will also be responsible for the oversight of new hospitals, clinics and their locations.

Veterans Affairs

Initially the department of Veterans’ Affairs will remain independent, but after 10 years Congress will evaluate the system and make determination to integrate their system with USNHI.

Advantages to Single Payer System

Proponents argue that a centralized billing system will be cheaper. There will be less paperwork. They also argue that they can reduce the medical bureaucracy and reduce errors.

Since everyone will be covered, no citizen shall be denied medical treatment because they are unable to pay or they have a pre-existing condition that prohibits or limits coverage by an insurance company. No one will have to sell their house because they got sick.

The plan will also cover indigent persons and employees between jobs. If you lose your job, you do not lose your coverage.

Disadvantages of a Single Payer Medical System

Critics argue that a government run program would end up costing more. Already Americans pay more per person than any other country in the world for health care, and this could increase the cost even more.

The quality of health care could decline if the bill passes Congress and is signed by the President. Critics say you don’t want your hospitals run like the Department of Motor Vehicles (DMV).

By Dan Wilson
Best Syndication News Writer